Diabetes and Heart Disease Awareness Healthy Living with Diabetes sm and Heart Healthy Living sm Utah Newsletter Spring 2011 What is Cardiovascular Disease (CVD)? Cardiovascular Disease (CVD) is used to describe a group of diseases and conditions. It refers to any disorder in the cardiovascular system. The cardiovascular system is made up of your heart and your blood vessels. So, CVD can mean diseases of the heart or diseases of the blood vessels. You can be born with some types of CVD. You can also get CVD later in life. Diseases of the heart can include coronary artery disease (CAD) and heart failure. CAD is a disease of the arteries that supply the heart muscle with blood. Your heart pumps blood all over your body, but it needs blood too. The coronary arteries feed the heart with blood. These vessels can get clogged with plaque. CAD can cause chest pain and heart attacks. Heart failure is also called congestive heart failure. It means that your heart doesn t pump enough blood to your organs and tissues. You might hear it in terms of right-sided heart failure and left-sided heart failure. If the right side of the heart doesn t pump hard enough, the blood backs up. This can cause swelling in the legs. If the left side of the heart doesn t pump hard enough, the blood backs up into the lungs. This can cause shortness of breath. Diseases of the blood vessels can include atherosclerosis, high blood pressure, stroke and aneurysm. Atherosclerosis is when arteries get hard because of fatty deposits. Fatty deposits are also called plaque. When the arteries get narrow it could lead to chest pain or a heart attack. High blood pressure is the most common form of CVD in the United States. It means that there is too much force placed on the vessel walls. This high force, if not controlled, can cause a stroke or heart failure. A stroke is a sudden loss in brain function. Your brain needs the oxygen carried in your blood. It cannot last long without it. A stroke is when the brain is deprived of oxygen because there is a clot blocking the vessel, or the vessel burst open. An aneurysm is when there is a weakness in the vessel wall. This weakness causes a bulge in the vessel. It is very sensitive and can burst. In This Issue What is Cardiovascular Disease pg 1 Foot Care with Diabetes pg 2 Taking Your Medicine pg 3 What is Carbohydrate Counting? pg 4 Low Blood Glucose (sugar) pg 5 Nurse Advice Line pg 6 Need Help Quitting Smoking? If you need help quitting, join Molina Healthcare s Smoke Free Program. Call 1-866-891-2320 for one-on-one help. You are receiving this newsletter as part of a Disease Management Program. If you do not want to receive this newsletter or participate in any Disease Management Program please let us know. Please call us at 1-866-891-2320. All material in this newsletter is for information only. This does not replace your provider s advice. These are just some of the types of CVD. If you have CVD it is important to know more about your disease and how to best manage it. www.molinahealthcare.com 1
Foot Care with Diabetes Why the concern about my feet? High blood sugar from diabetes causes two problems with your feet. 1. High sugar in your blood can damage nerves in your legs and feet. 2. High sugar in your blood can also slow down the flow of blood to your legs and feet. A sore or infection may take longer to heal. If you smoke and have diabetes this makes blood flow problems much worse. You may have heard about someone with diabetes who has had an amputation. If you take care of your feet every day this does not have to happen. What can you do to take care of your feet? Wash your feet in warm water every day. Do not use hot water. Do not soak your feet. Dry your feet well, even between your toes. Look at your feet every day. Check for sores, blisters, redness, calluses, or other problems. Use a mirror if you cannot check your feet by lifting them up. You can also ask someone else to check your feet. Always wear socks or panty hose. Do not wear socks or stockings that are too tight below your knee. Wear shoes that fit well. Buy shoes made of canvas or leather. Shop for shoes at the end of the day when your feet are bigger. Break in shoes slowly. Wear them one to two hours each day for the first one to two weeks. When buying new shoes, take a piece of paper and draw the outline of your foot. Place your shoe on top of the outline. If you can see the outline of your foot, your shoes are too small. What can you do at your provider visits? Take off your shoes and socks at every visit. Ask your provider to look at your feet. Ask your provider to check the feeling in your feet. Tell your provider about any pain in your feet or legs. Take care of yourself from head to toe! Adapted from the National Diabetes Clearinghouse Website Publication Tell your provider right away about any foot problems. Do not let small problems become big problems. Rub lotion on your feet after you wash and dry them if your skin is dry. Do not put lotion between your toes. File corns and calluses gently. Do this after your bathe or shower. Use an emery board or pumice stone. Move the emery board in only one direction only. Cut your toenails once a week. Cut toenails after a bath or shower when they are soft. Cut them in the shape of the toe and not too short. Do not cut into the corners because you might cut the skin. If you cannot cut your own toenails, ask a friend or family member to do this for you. Get help for corns and calluses. Never walk barefoot. Always wear shoes or slippers, even when you are at home. 2 www.molinahealthcare.com
Low Blood Glucose (sugar) What is low blood glucose? In most people with diabetes, a blood glucose number lower than 70 mg/dl is too low. What causes low blood glucose? If you take insulin or diabetes pills, you can have low blood glucose. (This is called hypoglycemia.) Low blood glucose can be caused by: eating less or later than normal. being more active than normal. taking too much diabetes medicine. drinking beer, wine, or liquor. Low blood glucose happens more often when you re trying to keep your glucose level near normal. Talk this over with your provider and diabetes educator. This is not a reason to stop trying to control your diabetes. It just means you have to be careful and watch for low levels. What are signs of low blood glucose? You may have low blood glucose if you feel: nervous shaky sweaty dizzy The signs of low blood glucose may be mild at first. If not treated, a low glucose level can quickly drop much lower. When your glucose level is very low, you may get confused, pass out, or have seizures. You should test your blood glucose if you can. If it is low, treat a low blood glucose level. If you have signs that your blood glucose is low and you cannot test it, go ahead and treat it. Treat every 15 minutes until your glucose level is at least 70 mg/dl. How do you treat low blood glucose? 1. Eat 10 to 15 grams of carbohydrates (carbs) right away. This could be: 3 to 4 glucose tablets (You can get these at a drug store. These are good to carry with you. You would eat them if needed.) 2 to 3 packets of sugar. Do not use sweeteners, such as sweet n low, equal or Splenda, to treat low blood sugar. ½ cup (4 oz.) fruit juice ½ cup (4 oz.) soda pop (not diet soda) 3 to 5 pieces hard candy 3 teaspoons sugar or honey 2. Check your blood glucose in 15 minutes. 3. Eat another 10 to 15 grams of carbs every 15 minutes until your blood glucose is above 70 mg/dl. 4. Ask yourself if your next planned meal or snack is more than 30 minutes away. If yes, eat something like crackers and a slice of cheese or spoonful of peanut butter. 5. Write down the numbers in your testing log book. Note the date and time. Think about what may be the cause of your low blood glucose. Write the reason beside the number. 6. Call your healthcare provider. Ask if you need to change your diet, activity or diabetes medicine. Tell family members, close friends, teachers, and people at work that you have diabetes. Tell them how to treat low blood glucose. If you use insulin, ask your provider about getting Glucagon. How do you prevent low blood glucose? Stay close to your normal schedule of eating, activity, and medicine. You may need to eat a snack if you are late eating a meal. You may also need a snack if you are more active than normal. Be safe and always check your glucose before you: Drive a car, truck, or SUV. Use heavy equipment. Exercise very hard. Exercise for more than 30 minutes. (The best time to exercise is one to two hours after a meal.) How do you stay prepared? Always carry some type of fast acting carb with you. You can then treat a low glucose level if needed. Always wear something that says you have diabetes. This might be a bracelet or necklace. Carry a card in your wallet that says you have diabetes. This is really important if you take medicine for your diabetes. www.molinahealthcare.com 5
Taking Your Medicine: Important Tips You Should Know Medicine is taken to help you manage or treat a condition or illness. Medicine can become dangerous if it is not taken correctly or if it reacts with another medicine. Here are a few tips to make sure you are up-to-date with the medicine you are taking. Tip #1: Knowing about your medicine Create a list of the medications you take. Make sure to update this list any time your provider makes changes to your medicine. It is important to review your list of medicines with your provider, so bring this list with you to each visit with your provider. The list should include the following: Name: What is the name of the medicine? Amount: How much do you take? When: When do you take the medicine? Purpose: Why are you taking the medicine? What is it supposed to do? Include any other non-prescription medicines, over-thecounter medicines, herbs, and vitamin supplements on your list. These may interact with the prescription medicines, so it s important for your provider to know everything you are taking. Make notes of any side effects that you have from your medicine and make sure to discuss with your provider. Tip #2: Taking your medicine In order for your medicine to do its job, you must take it as your provider prescribed. It may be hard to remember to take it sometimes when you go about your day. Here are some tips to help you keep on track with taking your medications: Take it at the same time everyday Take it together with other daily events, like brushing your teeth Use a pill box Ask someone close to you to help remind you Make yourself a reminder note and place it somewhere so you will see it everyday Always take your medicine the way your provider told you to take it. Taking too much or skipping doses can be dangerous. Do not stop taking your medicine unless your provider tells you to stop taking it. Tip #3: Medicine safety Use the same pharmacy to pick up all of your medicines. Do not share medicines. Do not use medicine that has expired. Let your provider know if you have any allergies to medicines. Keep your medicine out of reach from pets and children. Keep your medicine away from heat and damp areas. www.molinahealthcare.com 3
What is Carbohydrate Counting? What is Carbohydrate Counting? Carbohydrate counting is an important part of a healthy eating plan for all people living with diabetes. Of all the things you eat, carbohydrates raise your blood glucose the most. Carbohydrate also raises blood glucose (sugar) levels after meals faster than protein, fats or other nutrients. It s the balance between the carbohydrates you eat and insulin that determines how much your blood glucose level rises after you eat. How do I count carbohydrate grams? Carbohydrate grams are printed on food labels. To count them, you will need to add up the carbohydrate grams in each of the foods you eat. Food labels are not always available on fresh fruits and vegetables or other carbohydrates that do not come in a package (foods bought in bulk or homemade sweets). What are the right serving sizes? The amount of carbohydrates you eat can make a big difference in your blood glucose. One carbohydrate serving equals 15 grams (g) of carbohydrates. In order to make the counting simple, you can round up. For example, round up the number of grams of carbohydrates in a cup of milk from 12 g to 15 g. Approximately one serving of carbohydrate equals: 1 slice of bread, 6 crackers, ¼ bagel, or 1 tortilla (6 inch) ¾ cup dry cereal, or ½ cup cooked cereal ⅓ cup cooked pasta, or ⅓ cup rice 1 small piece of fruit, ½ cup fruit juice or canned fruit ½ cup corn, potatoes or peas ½ cup pinto or kidney beans 1 cup milk 2-inch square cake, 2 cookies, or ½ cup light ice cream 3 cups popcorn (popped), ¾ ounce pretzels or potato chips (about 15-20) How many carbohydrate servings should I eat? The recommended number of carbohydrate servings is based on your weight, activity level, medications, and goals for your blood glucose levels. For many people the following number of servings works well. Meals 3 or 4 carbohydrate servings (45-60 g) Snacks 1 or 2 carbohydrate servings (15-30 g) Speak with your healthcare provider or diabetes educator to determine what is right for you. How to use food labels To determine serving size, check the label for the total number of carbohydrate grams (g). Remember one carbohydrate serving is equal to 15 grams of carbohydrate. If the total carbohydrate count is 15 grams, check the food label for the serving size. Nutrition Facts Serving size: 6 crackers Total carbohydrates: 15 g One carbohydrate serving is 6 crackers If the total carbohydrate count is more than 15, divide the total by 15 Nutrition Facts Serving size: 4 cookies Total carbohydrate: 30 g One carbohydrate serving is 2 cookies, since 30 divided by 15 equals 2 If the total carbohydrate count is less than 15 grams, multiply the serving size so that the serving will have 15 grams of carbohydrates Nutrition Facts Serving Size: 1 piece Total carbohydrates: 5 g One carbohydrate serving is 3 pieces, since 5 multiplied by 3 equals 15 4 www.molinahealthcare.com
7050 South Union Park Center, Suite 200 Midvale, UT 84047 5438DM0311 Questions about your health? Call Our Nurse Advice Line! English: 1-888-275-8750 Spanish: 1-866-648-3537 OPEN 24 HOURS! Your family s health is our priority! For the hearing impaired, please call TTY (English): 1-866-735-2929 TTY (Spanish): 1-866-833-4703 or 711 6 www.molinahealthcare.com